World Menopause Day

Menopause: Cognition and Mood

By Aisha Musa Auyo

World Menopause Day (WMD) is held annually on the 18th of October. The purpose of the day is to raise awareness of menopause and the support options available for improving health and well-being. Professionals and women are encouraged to participate in this global awareness-raising campaign by printing and sharing these materials, organising events to engage their communities, and sharing WMD social media posts. The theme for the 2022 WMD is Cognition and Mood

Before going into this year’s theme, I’ll explain the basics of menopause as a reminder and enlightenment for those who do not know much about it.

Menopause happens to most women with an average age of 51 years, but it’s normal to have menopause anywhere between 45 and 55 years – although some women have it earlier or later. Perimenopause is the time leading up to menopause, and postmenopause is the time after the final period. So it’s likely that you have reached menopause if you haven’t had a period for 12 months.

What happens at menopause?

From about 35–40 years of age, a woman has fewer eggs left in the ovaries, so one often doesn’t ovulate (release an egg from your ovary) regularly. Menopause means ovulation and periods stop.

Hormones are chemicals in one’s body that relay messages through the bloodstream. For example, your hormones tell your body to eat and sleep. The three main hormones that change as one approaches menopause are oestrogen, progesterone, and testosterone; change in hormone levels leads to different menopausal symptoms and the menopause transition

1. Perimenopause is the stage before your final period (menopause). It’s when your body reaches the end of its reproductive years. Perimenopause is a natural part of a woman’s life, and it usually happens sometime in her 40s. On average, it lasts four to six years but can also last from one to 10 years.

During this time, your ovaries begin to run out of eggs. This causes hormone levels, particularly oestrogen, to fluctuate, causing different symptoms like hot flashes and mood swings. Changing hormones can also affect your menstrual cycle. For example, your periods may be irregular, shorter (or longer), lighter (or heavier), or they may not come for a few months.

Some months you may ovulate, and other months you may not. You may even ovulate twice in a cycle. Symptoms include: Irregular periods, vaginal dryness, hot flashes, chills, night sweats, sleep problems, mood changes, weight gain and slowed metabolism.

2. Menopause occurs when you’ve stopped producing the hormones that cause your menstrual period and have gone without a period for 12 months in a row. Once this has happened, you enter postmenopause.

3. Post-menopause is the time after menopause has occurred. Once this happens, you’re in post-menopause for the rest of your life. Your hormone levels will remain low, and you will no longer have a monthly period. You can’t get pregnant because your ovaries have stopped releasing eggs.

Most people in post-menopause feel lingering symptoms from menopause. However, the symptoms are less intense. In some cases, they almost disappear. Lingering symptoms are caused by low levels of reproductive hormones. Women in post-menopause can feel symptoms such as hot flashes and night sweats, vaginal dryness and sexual discomfort, depression, changes in sex drive, insomnia, dry skin, weight changes, hair loss and urinary incontinence.

Talk with your healthcare provider if your symptoms become more intense or interfere with your daily life. They may want to rule out any underlying condition causing these symptoms.

How do I manage symptoms of post-menopause on my own? Particular lifestyle or at-home changes can help you manage symptoms of postmenopause. Some of these include:

• Using a water-based vaginal lubricant during sex to make it more pleasurable. Lubricating the vagina helps with dryness and pain.

• Regular exercise, meditation and other relaxing activities can help with depression and other side effects of postmenopause.

• Eating a diet rich in phytoestrogens (plant-based sources of estrogen) such as whole-grain cereals, flaxseed, chickpeas and legumes. Reducing caffeine and alcohol intake has also been shown to help.

Cognition and mood in menopause

Cognition

During the menopausal transition, many women complain of memory problems such as difficulty with words, forgetfulness and “brain fog”, thus suggesting that hormonal changes related to menopause may be responsible for changes in cognition. This is due to the deep connection between estrogen and cognitive function. Still, some lifestyle changes one can make may ease symptoms and improve memory.

For example, you should eat a well-balanced diet; a diet high in low-density lipoprotein (LDL) cholesterol and fat may be bad for your heart and brain. Also, get enough rest, and exercise your body and mind.

Mood

Irritability and feelings of sadness are the most common emotional symptoms of menopause. Often, they can be managed through lifestyle changes, such as learning ways to relax and reduce stress. Here are some tips that may make it easier for you to handle your fluctuating emotions: Exercise and eat healthily; find a self-calming skill to practice, such as yoga, meditation, or rhythmic breathing; avoid tranquilisers and alcohol; engage in a creative outlet that fosters a sense of achievement; stay connected with your family and community; nurture your friendships.

Supporting someone through the menopause

Menopause can be associated with many physical and emotional changes for women, making it a challenging and complicated time.

If you know someone who might be going through menopause or perimenopause, it’s helpful to find out more about how you can support them. For example, some women will drop out of the workforce if not supported. Adapting working policies, such as providing access to flexible working, can help women remain in the workplace.

Learn more about menopause

Getting yourself and others informed is a significant step. It will give you an idea of what your partner, family member, friend or colleague might be going through.

A good first step would be to learn about all the various symptoms of menopause, the impact these symptoms may have on your loved one and others, and the potential treatments and support available.

Listen to them

Communication is key. Ask about how others feel or what they’re going through. It’s essential to keep in mind that not everyone might want to talk about specific symptoms or feelings. It is also important to remember that everyone’s menopause is different, so don’t make assumptions about what they are experiencing. However, letting them know you’re there if they need you will make them feel supported.

Encourage them

They might not feel like doing things they usually would, and their self-esteem might be low. Words of encouragement can help make them feel more uplifted and empowered. Inviting them to engage with various people or activities will also provide opportunities to feel good about themselves even when experiencing symptoms.

Help with their symptoms

An active, healthy lifestyle can ease some of the symptoms of menopause. For example, you can encourage them to go for a walk, swim or try a yoga class to get more active. In addition, changing the ways you spend time together, like cooking a healthy meal together.

Menopause and the workplace

Many women have said that they often find managing symptoms of menopause in the workplace very challenging. Coping with symptoms in the workplace can be hard, especially as many women find it difficult to talk about menopause at work.

Workplaces

It is vital that women feel supported to continue working throughout their menopause. Managers and organisations can make many small changes to ensure workplaces are healthy and welcoming places for women going through menopause.

Supporting staff

Menopause is a normal transition for many women. Thus, employers can contribute to a positive work environment by providing help and support for women who are managing menopause symptoms at work.

Menopausal symptoms can also be protected by employment law. Therefore, it is crucial that managers and colleagues feel informed and comfortable about the symptoms and impact of menopause.

Aisha Musa Auyo is a Doctorate researcher in Educational Psychology, a mother of three, a Home Maker, caterer and parenting/ relationship coach.